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Prediction of skull base osteomyelitis in necrotising otitis externa with diffusion-weighted imaging

Published online by Cambridge University Press:  05 June 2020

A A K Abdel Razek  and
W Mahmoud
A A K Abdel Razek*
Affiliation:
Department of Diagnostic Radiology, Mansoura University Faculty of Medicine, Mansoura, Egypt
W Mahmoud
Affiliation:
Department of Diagnostic Radiology, Mansoura University Faculty of Medicine, Mansoura, Egypt
*
Author for correspondence: Dr Ahmed Abdel Khalek Abdel Razek, Department of Diagnostic Radiology, Mansoura University Faculty of Medicine, Elgomheryia Street, Mansoura, Egypt3512 E-mail: arazek@mans.edu.eg Fax: +20 502 259 146
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Abstract

Objective

To predict skull base osteomyelitis in patients with necrotising otitis externa using diffusion-weighted imaging.

Methods

A retrospective analysis was conducted of 25 necrotising otitis externa patients with skull base osteomyelitis (n = 10) or without skull base involvement (n = 14) who underwent a single-shot diffusion-weighted imaging of the skull base.

Results

The respective mean apparent diffusion coefficient values of the skull base, as determined by two reviewers, were 0.851 ± 0.15 and 0.841 ± 0.14 ×10-3mm2/s for the skull base osteomyelitis patients, and 1.065 ± 0.19 and 1.045 ± 0.20 ×10-3mm2/s for the necrotising otitis externa patients without skull base involvement. The difference in apparent diffusion coefficients between the groups was significant, for both reviewers (p = 0.008 and 0.012). The optimal threshold apparent diffusion coefficient for predicting skull base osteomyelitis in necrotising otitis externa patients was 0.945 ×10-3mm2/s and 0.915 ×10-3mm2/s, with an area under the curve of 0.825 and 0.800, accuracy of 87.5 and 83.3 per cent, sensitivity of 85.7 and 90.0 per cent, and specificity of 90.0 and 78.6 per cent, for each reviewer respectively.

Conclusion

Apparent diffusion coefficient is a non-invasive imaging parameter useful for predicting skull base osteomyelitis in necrotising otitis externa patients.

Keywords

Magnetic Resonance ImagingOsteomyelitisInfectionOtitis ExternaSkull Base
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 5 , May 2020 , pp. 404 - 408
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Dr A A K Abdel Razek takes responsibility for the integrity of the content of the paper

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